Provider Demographics
NPI:1629159207
Name:SICURO, FRANCO (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCO
Middle Name:
Last Name:SICURO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10199 WOODFIELD LANE, SUITE 10
Mailing Address - Street 2:
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2922
Mailing Address - Country:US
Mailing Address - Phone:314-298-0023
Mailing Address - Fax:314-298-0020
Practice Address - Street 1:10199 WOODFIELD LN STE 10
Practice Address - Street 2:
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-2922
Practice Address - Country:US
Practice Address - Phone:314-298-0023
Practice Address - Fax:314-997-1111
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1128062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO112806OtherSTATE LICENSE
MO17086OtherBNDD NUMBER
371 791 5OtherECFMG NUMBER
MO208859900Medicaid
MO208859900Medicaid
MOE53164Medicare UPIN
MO006012493Medicare ID - Type Unspecified